09/09/2026
US Health Insurance Cost Tradeoffs Ahead | Nursing home
We’ve seen uninsured rates in the US reach historic lows in recent years, but as pandemic-era tax credits expired at the end of 2025, more than 2.5 million fewer people enrolled in marketplace coverage for 2026. Having worked for over a decade as an independent insurance broker, advocating for clients as they navigate these complex changes, I see how new work requirements and funding shifts in the state-federal program are projected to further reduce enrollment by about 7.6 million people by 2034. While these changes might trim federal health spending, states face tough choices—balancing the loss of federal funds, potential savings from lower coverage costs, and the ongoing need for rural support. State efforts, like capping annual health cost growth, haven’t led to sustained premium or hospital price reductions, largely because enforcement remains limited. There may be more promise in simplifying insurance administration to cut costs while maintaining quality, though it could also mean fewer plan options. My focus is always on helping individuals—especially those nearing retirement—understand how these shifts can affect their choices and access to care.
